Suzuki N, Takanashi Y, Tokuhiro K, Yoshihara K, Shiono N, Komatsu H
Department of Thoracic and Cardiovascular Surgery, Toho University School of Medicine, Tokyo, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Dec;40(12):2222-6.
Mitral valve replacement with 19 mm St. Jude Medical mechanical valve was successfully performed for congenital mitral regurgitation in an infant aged 3 months. The infant had undergone ligation of ductus arteriosus at the first month of age. Ten days after the operation, he was discharged, though having systolic murmurs. One month later, however, he was re-admitted for progressive heart failure. After hospitalization, he had to be supported mechanical ventilation. The second operation was needed for intractable heart failure, that was considered to be caused by mitral regurgitation, on an emergency basis without cardiac catheterization. The mitral valve was hypoplastic and the leaflet and chordae were gelatinous. Therefore, mitral valvuloplasty was considered to be impossible, and consequently mitral valve replacement was chosen. Postoperatively the patient's condition remarkably improved. Anticoagulation therapy with sodium warfarin and dipyridamole was maintained after operation. At present the patient is growing without any symptom.
采用19毫米圣犹达医疗机械瓣膜为一名3个月大的婴儿成功实施二尖瓣置换术，治疗先天性二尖瓣反流。该婴儿在1月龄时接受了动脉导管结扎术。术后10天，尽管仍有收缩期杂音，他还是出院了。然而，1个月后，他因进行性心力衰竭再次入院。住院后，他不得不依靠机械通气维持生命。由于顽固性心力衰竭，在未进行心导管检查的紧急情况下，需要进行第二次手术，心力衰竭被认为是由二尖瓣反流引起的。二尖瓣发育不全，瓣叶和腱索呈胶冻状。因此，二尖瓣成形术被认为是不可能的，所以选择了二尖瓣置换术。术后患者病情显著改善。术后维持华法林钠和双嘧达莫抗凝治疗。目前，患者成长过程中无任何症状。
